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Postnatal unit bassinet types when rooming-in after cesarean birth: implications for breastfeeding and infant safety
Kristin P Tully1, Helen L Ball
1University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. kristin.tully@unc.edu
Background:
Postnatal unit rooming-in promotes breastfeeding. Previous research indicates that side-cars (3-sided bassinets that lock onto the maternal bed frame) facilitate breastfeeding after vaginal birth more than stand-alone bassinets (standard rooming-in). No study has previously investigated side-car bassinet use after cesarean, despite the constraints on maternal-infant interactions that are inherent in recovery from this birth mode.
Objective:
To test the effect of the side-car bassinet on postnatal unit breastfeeding frequency and other maternal-infant behaviors compared to a stand-alone bassinet following cesarean birth.
Methods:
Participants were recruited and prenatally randomized to receive the side-car or stand-alone bassinet for their postnatal unit stay between January 2007 and March 2009 in northeastern England. Mother-infant interactions were filmed over the second postpartum night. Participants completed face-to-face interviews before and after filming. The main outcome measures were infant location, bassinet acceptability, and breastfeeding frequency. Other outcomes assessed were breastfeeding effort, maternal-infant contact, sleep states, midwife presence, and infant risk.
Results:
Differences in breastfeeding frequency, maternal-infant sleep overlap, and midwife presence were not statistically significant. The 20 dyads allocated to side-car bassinets breastfed a median of 0.6 bouts/ hour compared to 0.4 bouts/hour for the 15 stand-alone bassinet dyads. Participants expressed overwhelming preference for the side-car bassinets. Bed sharing was equivalent between the groups, although the motivation for this practice may have differed. Infant handling was compromised with stand-alone bassinet use, including infants positioned on pillows while bed sharing with their sleeping mothers.
Conclusions:
Women preferred the side-car, but differences in breastfeeding frequency were not statistically significant. More infant risks were observed with stand-alone bassinet use.
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